Secondary service connection
Intervertebral disc syndrome secondary to an ankle condition: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided intervertebral disc syndrome claimed as secondary to an ankle condition in 464 decisions. It granted the issue in 17.2% of them, close to the 19.2% grant rate for all intervertebral disc syndrome issues, denied it in 16.4%, and remanded it in 64.7%. Counting only decisions on the merits, 51.3% were granted.
From Board of Veterans' Appeals decisions: appeals, not VA's first decisions. About these numbers
Decisions
464
2017–2026
Granted
17.2%
All intervertebral disc syndrome: 19.2%
Granted on the merits
51.3%
Granted ÷ (granted + denied)
Remanded
64.7%
Denied: 16.4%
At a glance
- Most often argued link: altered gait or overuse, named in 121 issues, 28.9% granted. Details
- Causation only: 24.2% granted; when the decision discussed aggravation: 10.6%. Details
- Positive nexus opinion: 82.7% granted on the merits when in the record, 22.2% without. Details
- Private medical opinion: 66.7% granted on the merits when in the record, 24.6% without. Details
- Issues granted: 14.0% in 2019, 19.2% in 2025. Details
How these claims are argued
A secondary claim says an ankle condition caused intervertebral disc syndrome or made it worse, and names how. Below: whether the Board's decision discussed aggravation, and the medical link each decision names, with how often those issues were granted.
Aggravation discussed
made worse by the disability, 3.310(b)
10.6%
granted, of 235 issues (50.4% of all)
Causation only
caused by the disability, 3.310(a)
24.2%
granted, of 231 issues (49.6% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Altered gait or overuse Granted “The Board found that the chronic pain and weakness in the left ankle led to compensatory weight-shifting and an antalgic gait, which in turn caused the current low back condition.” A25039281 (2025) Denied “Veteran's lay testimony attributed gait changes to post-service stroke.” 25002589 (2025) | 121 | 28.9% |
Nerve involvement Granted “Service connection for the Veteran's lower back disabilities, including lumbosacral strain, intervertebral disc syndrome (IVDS), and radiculopathy, was granted as secondary to his service-connected knee instability, knee strain, ankle...” A25018509 (2025) Denied “The Board found a current diagnosis of degenerative arthritis, intervertebral disc syndrome, radiculopathy, and lumbar pain.” 25002136 (2025) | 18 | 22.2% |
Weight gain or obesity Denied “Post-service factors (aging, obesity, MVA) attributed to current disability.” 20071775 (2020) | 17 | 0.0% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 33.3% of the 466 issues name at least one medical link; the rest only say “secondary to” the disability. One issue can name several links. Granted is the share of those issues granted (remands count as not granted). A link named in a denial was often the argument the Board rejected.
Evidence in granted and denied intervertebral disc syndrome decisions
For each kind of supporting evidence: how often the Board granted the intervertebral disc syndrome issue on the merits when the decision mentioned it, compared with decisions that did not. These are associations, not causes, and evidence is recorded per decision, not per issue.
| In the record | Decisions | Granted when present | When absent | Difference |
|---|---|---|---|---|
| Positive nexus opinion | 101 | 82.7% | 22.2% | +60.4 pts |
| Private medical opinion | 174 | 66.7% | 24.6% | +42.1 pts |
| Favorable VA exam | 40 | 64.3% | 48.4% | +15.8 pts |
| Lay statement | 385 | 43.8% | 88.5% | −44.6 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 85.0% of the decisions that granted intervertebral disc syndrome.
- The Board found the veteran's statements credible in 20.0% of grants and 17.1% of denials.
Negative evidence in the record
An unfavorable exam or a negative nexus opinion often sits in the same record as favorable evidence, and the Board weighs them against each other. So these rows show how often intervertebral disc syndrome was still granted when the record contained the negative item, not that the item helped.
| In the record | Decisions | Granted when present | When absent | Difference |
|---|---|---|---|---|
| Negative nexus opinion | 332 | 48.7% | 59.0% | −10.3 pts |
| Unfavorable VA exam | 387 | 45.6% | 90.0% | −44.4 pts |
Recent intervertebral disc syndrome decisions
Granted
Favorable finding of current lumbosacral strain diagnosis and service-connected right ankle tendonitis.; Deficient VA opinions found to have low probative weight.; Competent, credible, and probative private medical opinion establishing nexus.
Low back disability found secondary to service-connected left ankle disability.; Criteria for secondary service connection met.
Favorable finding of current diagnosis for lumbosacral strain.; Favorable finding of service connection for left ankle sprain.; Inadequate VA exam opinion on aggravation.; Probative private medical opinion linking lumbosacral strain to ankle sprain.; Evidence in approximate balance.; Benefit of the doubt applied.
Denied
Lack of continuity of symptomology from service; Persuasive weight of evidence against nexus; VA opinions found less likely than not related to service-connected disabilities
August 2024 VA examiner opined low back disorder unrelated to service-connected knee/ankle conditions.; Medical literature does not support causal relationship between joint injuries and low back disorders via altered gait.; Veteran's claimed neck pain predated reports of limp; work-related lifting exacerbated pain.
Secondary to denied left ankle condition.; No direct service connection asserted or established.
Intervertebral disc syndrome secondary to an ankle condition: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 23 | 17.4% | 34.8% | 47.8% | 0.0% |
| 2018 | 44 | 22.7% | 22.7% | 52.3% | 2.3% |
| 2019 | 50 | 14.0% | 18.0% | 64.0% | 4.0% |
| 2020 | 71 | 12.7% | 12.7% | 70.4% | 4.2% |
| 2021 | 53 | 26.4% | 7.5% | 66.0% | 0.0% |
| 2022 | 45 | 8.9% | 20.0% | 66.7% | 4.4% |
| 2023 | 61 | 11.5% | 13.1% | 75.4% | 0.0% |
| 2024 | 49 | 24.5% | 12.2% | 63.3% | 0.0% |
| 2025 | 52 | 19.2% | 25.0% | 55.8% | 0.0% |
Each row counts issues (each condition the Board decided), so the shares add up to 100%. Other: dismissed, withdrawn or no clear outcome. Years with fewer than 20 issues are left out.
Why the Board granted or denied intervertebral disc syndrome
Most common reasons in grants
- Caused by the service-connected disability16
- Service connection established7
- Current diagnosis established7
- Aggravated by the service-connected disability5
- VA examiner: less likely than not related to service2
Most common reasons in denials
- VA examiner: less likely than not related to service18
- No in-service complaints, treatment or diagnosis13
- Preponderance of the evidence against the claim13
- Current diagnosis established6
- Service records negative or silent6
- Aggravated by the service-connected disability3
- Evidence persuasively weighs against service connection2
- No evidence of functional loss equivalent to ankylosis2
Numbers are decisions that gave the reason. Reasons are short phrases extracted by AI from each decision; common wordings of the same reason are grouped. Benefit of the doubt is reported above.
Background
What VA needs to grant a secondary claim
Secondary service connection means VA disability benefits for a condition caused or made worse by a disability that is already service connected (38 CFR 3.310). The claim needs three things:
- A current diagnosis of intervertebral disc syndrome.
- An ankle condition is already service connected.
- Medical evidence linking them (a nexus opinion): intervertebral disc syndrome was caused by an ankle condition (3.310(a)), or was made worse beyond its natural progress by it (aggravation, 3.310(b)).
VA's procedures for these claims are in M21-1 V.ii.2.D. When the evidence for and against is about even, VA must decide in the veteran's favor (38 CFR 3.102).
How VA rates intervertebral disc syndrome
Once service connection is granted, VA assigns a disability rating from the rating schedule, 38 CFR 4.71a, diagnostic code 5243 (Intervertebral disc syndrome: Assign this diagnostic code only when there is disc herniation with compression and/or irritation of the adjacent nerve root; assign diagnostic code 5242 for all other disc diagnoses). The rating is the same whether the condition is service connected directly or as secondary to another disability.
| Rating | Criteria |
|---|---|
| 60% | With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months |
| 40% | With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months |
| 20% | With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months |
| 10% | With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months |
| | Rating |
- Note: If traumatic paralysis does not cause loss of use of both hands or both feet, it is incomplete paralysis. Evaluate residuals of incomplete traumatic paralysis under the appropriate diagnostic code (e.g., § 4.124a, Diseases of the Peripheral Nerves).
- Note (1): For purposes of evaluations under diagnostic code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician.
- Note (2): If intervertebral disc syndrome is present in more than one spinal segment, provided that the effects in each spinal segment are clearly distinct, evaluate each segment on the basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of the Spine, whichever method results in a higher evaluation for that segment.
Text of 38 CFR 4.71a as of Feb 27, 2026. Confirm the current text at the source before relying on it.
See all intervertebral disc syndrome decisions, direct and secondary.
Other conditions secondary to an ankle condition
Intervertebral disc syndrome secondary to other conditions
See all conditions secondary to an ankle condition or back conditions as a primary or secondary condition.
Rules that apply to secondary intervertebral disc syndrome claims
- 38 CFR 3.310
Secondary service connection and aggravation
Read it in VA Law Explorer - M21-1 V.ii.2.D
Secondary service connection and aggravation of non-service-connected disabilities
Read it in VA Law Explorer - 38 CFR 3.102
Reasonable doubt (benefit of the doubt)
Read it in VA Law Explorer - 38 CFR 4.71a · DC 5243
Schedule of ratings: musculoskeletal system
Read it in VA Law Explorer - M21-1 V.iii.1.B.3
Spine: evaluating IVDS and incapacitating episodes
Read it in VA Law Explorer - M21-1 V.iii.1.A
Painful motion and functional loss (38 CFR 4.59, DeLuca, Mitchell, Correia)
Read it in VA Law Explorer
Research your intervertebral disc syndrome case
Narrow by year, judge, evidence or secondary condition, read the decisions, and export a research memo.
How these numbers are calculated
- Counts decisions in which the Board decided a intervertebral disc syndrome issue claimed as secondary to an ankle condition, by the outcome of that issue.
- The primary disability is read from the decision text ("secondary to …") and grouped by name, so spellings such as "PTSD" and "posttraumatic stress disorder" count together.
- Secondary claims also include aggravation of a non-service-connected condition by a service-connected one (38 CFR 3.310(b)).
- The data comes from CaseScribe's AI extraction of public BVA decisions (2017–2026) and can contain errors. It is updated automatically as new decisions are added.
Where this data comes from
- Claim
- Regional office decides
- Veteran appeals
- Board decides
- Granted · Denied · Remanded: back to the regional office
Board of Veterans' Appeals decisions show how VA's highest review body applies 38 CFR and weighs evidence on contested claims.
Each one is an appeal: a regional office decided the claim first, and the veteran appealed. So these rates describe the Board, not a veteran's odds at the regional office, where most claims are decided and whose decisions are not public.
More on what Board decisions can and cannot tell you